4
Defining Sex, Gender, and Sexual Orientation
Sex
It has generally been assumed that human beings must biologically be of either the male or female sex. Whether an individual is identified as a biological male or female is premised on an evaluation of chromosomal sex, gonadal sex, and morphological sex and secondary sex traits (Herdt, 1994). Lillie’s thoughts on sexual dimorphism reflect this assumption that human must be either male or female:
What exists in nature is a dimorphism within species into male and female individuals, which differ with respect to contrasting characters, for each of which in any given species we recognize a male form and a female form, whether these characters be classed as of the biological, or psychological, or social orders. Sex is not a force that produces these contrasts;
it is merely a name for our total impression of the differences . . . In the strictly historical sense of these words, a male is to be defined as an individual that produces spermatozoa; a female one that produces ova; or individuals at least having the characters associated with these functions (Lillie, 1939).
The sexologist John Money made similar assumptions regarding the dichotomous nature of sex and its relationship to gender. Kessler (1998) has asserted that five basic premises provided the foundation to Money’s work: (1) genitals are natu- rally dimorphic; (2) genitals that blur this dimorphism require surgical correction;
(3) gender is dichotomous because genitals are dimorphic; (4) dimorphic geni- tals serve as markers of dichotomous gender; and (5) medical professionals have legitimate authority to define the relationship between gender and genitals.
In the usual course of events, the chromosomal sex of an embryo is determined by the fertilization of an ovum by either an X-bearing or a Y-bearing sperm.
Fertilization by an X-bearing sperm results in an XX zygote, which normally develops into a female. In contrast, fertilization by a Y-bearing sperm produces an XY zygote, which normally develops into a male (Moore and Persaud, 1993).
Prior to the seventh week of an embryo’s development, however, the gonads of both males and females are identical in appearance and are therefore referred to as indifferent or undifferentiated gonads. Sexual differentiation of the gonads will
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occur during the first half of fetal life, as will the development of the internal genital tract and the external genitalia (Josso, 1981). Hormonal sex will emerge at puberty and may affect one’s psychological sex (Josso, 1981). As will be seen in the discussion that follows, however, this process is not without variation.
Sexual Deviance
Variance from what has been considered the biological norm has often been as deviant, rather than a reflection of diversity (Brierley, 2000). The models that have been formulated to explain deviance are important in understanding the various approaches that have been adopted to explain and categorize sex, sexuality, and sexual behavior and, consequently, the issues that may arise in attempt to assess sex, gender, sexual orientation, and related constructs.
Brierley (2000) has identified five models of sexual deviance: the classifica- tory, psychodynamic, biological, sociological, and human rights models. Brierley uses the term “classificatory model” to label what others have referred to as the medical model. This model attempts to classify seemingly similar behaviors to- gether into diagnostic categories of illnesses that require treatment or cure. The psychodynamic model utilizes a similar approach in that variation is perceived as perversion that requires a remedy, often psychotherapy, to rechannel sexual inter- ests and desires. This approach has euphemistically been referred to as “change therapy,” implying that any distress experienced by the individual as a result of his or her “condition” is attributable to his or her inability to engage in socially desirable behavior. Neither the classificatory nor the psychodynamic models admit the likelihood or even possibility that it is society that requires a change or cure, rather than the individual. The biological model similarly presumes that deviation from the norm requires “fixing,” which can be effectuated through a variety of treatments that may include hormone therapy and surgery (Brierley, 2000).
Unlike the previously mentioned three models, the sociological and human rights models view the “problem” of “sexual deviance” as having been manufactured by the larger society. The sociological model focuses diversity of sexual behavior as a matter of statistical variation. The human rights model argues that by viewing sex- ual variation as deviance, society violates the rights of minority groups (Brierley, 2000).
Intersexuality, Hemaphroditism, and Pseudohermaphroditism
Discrepancy between the morphology of the gonads (testes or ovaries) and the appearance of the external genitalia results in intersexuality, also referred to as hermaphroditism. Although the terms are often used interchangeably, they embody differing perspectives about sexual ambiguity. Dreger (1998: 31) has explained:
“Intersexed” literally means that an individual is between the sexes—that s/he slips between and blends maleness and femaleness. By contrast the term “hermaphroditic” implies that a
person has both male and female attributes, that s/he is not a third sex or a blended sex, but instead that s/he is a sort of double sex, that is, in possession of a body which juxtaposes essentially “male” and essentially “female” parts.
Not only have individuals been classified as hermaphrodites or intersex, but those that have, have been subject to further classification of their sexuality.
The French surgeon Samuel Pozzi believed that one’s sex was dependent on one’s gonads (Dreger, 1998). He recommended during the early 20th century that hermaphrodites be classified as follows:
I. Asexed or oligosexed. Subjects indifferent or nearly indifferent from the sexual point of view.
II. Homosexed or inverted. Among these, we can admit a subdivision: In one category, the inversion appears very much to be a secondary effect of causes acting artificially, if we may say it this way, on the mentality and the habits of the subject [as though “mistaken” sexual education]. In another category, it seems that the inversion was original or innate.
III. Heterosexed or individuals having the sexual appetite directed toward women if they have testicles, toward men if they have ovaries. (It might be prefer- able . . . to call them orthosexed, that is to say, sexed in the normal direction (Dreger, 1998: 129–130).
It is evident from this classification system that hermaphroditism both pro- voked significant confusion and was erroneously equated with sexual orientation.
Some scholars, such as Jonathon Hutchinson, hypothesized in 1896 that sexual inversion [homosexuality] might be associated with overlooked or undetected hermaphroditic traits (Dreger, 1998). Ellis, a physician in London, posited:
It seems to me, on a review of all the facts that have come under my observation, that while there is no necessary connection between infantilism [the persistence of childish features], feminism [“feminine” features in a man], and masculinism [“masculine” features in a woman], physical and psychic, on the one hand, and sexual inversion on the other, yet there is a distinct tendency for the signs of the former group of abnormalities to occur with unusual frequency in inverts (Ellis, 1908: 171).
The analogy drawn between hermaphroditism and homosexuality permitted the inference that, like hermaphroditism, homosexuality, or inversion, was pathologi- cal and that intersex represented an inferior form of life because it existed between malehood and femalehood (Dreger, 1998). The consequences of this inference are discussed further in chapter 4.
In contrast, the teratologist Isidore Geoffroy Saint-Hilaire classified hermpahroditic individuals based on their possession of “excess” body parts. The first class, consisting of those individuals without excess body parts, were further classified into four orders based on the appearance of their sexual apparatus as essentially, female, male neuter, or mixed. The second class consisted of three orders: the complex masculine hermaphrodism [sic], which included individu- als bearing male sexual apparatus and supernumerary female parts; the complex feminine hermaphrodism [sic], such that they had female sexual apparatus and
supernumerary male parts; and bisexual hermpahrodism [sic], which referred to individuals with either complete male and female sexual apparatus or individuals in which one or both of the apparatuses were incomplete (Dreger, 1998). Other classification systems were also devised, including those of the obstetrician Simp- son, who categorized hermpahroditism into spurious and true.
Today, the medical literature tends to speak of hermaphroditism as being classifi- able into three distinct types: true hermaphroditism, male pseudohermaphroditism, and female pseudohermaphroditism (Dreger, 1998). True hermaphroditism is extremely rare and occurs only when both testicular and ovarian tissue are present. These tissues, however, are generally nonfunctional (Krob, Braun, and Kuhnle, 1994; Moore and Persaud, 1993; Talerman, Verp, Senekjian, Gilewski, and Vogelzang, 1990). The majority of true hermaphrodites appear to have an XX chromosomal basis, although some may have XY chromosomes and others exhibit chimerism, whereby some cells display XX chromosomes and others exhibit XY chromosomes. It is believed that chimerism occurs as the result of the fusion of two early embryos, one XX and one XY, into one individual. The genitalia of true hermaphrodites may appear “typically” male or female, or may appear otherwise (Dreger, 1998).
Approximately one-half of all instances of ambiguous external genitalia are believed to be individuals with female pseudohermaphroditism (Moore, 1989).
Female pseudohermaphroditism is characterized by the existence of ovaries and an XX chromosomal basis. As the result of exposure to high levels of the hormone androgen while in the womb, the external genitalia of these individuals appear masculinized, so that what is assumed to be the clitoris may look and act like a penis, and what is assumed to be the labia may resemble a scrotum. However, the internal organs appear to be those of a biological female.
There have been various theories advanced in an attempt to understand and ex- plain the masculinization of female pseudohermaphroditism. It has been suggested that a tumor on the suprarenal gland of the pregnant mother could result in the ex- cessive production of androgens, thereby effecting a “male” type development of the female child’s genitalia. Alternatively, masculinization of a female child could result from the administration of androgenic hormones to a pregnant women, for instance, in order to prevent a miscarriage. Finally, congenital adrenal hyperplasia, or CAH, may be responsible for the masculinization of a female child, through the production of large amounts of androgens by the adrenal glands. Although the fe- tus has an XX chromosomal basis and ovaries, the increased amount of androgens may result in the development of external genitalia associated with males (Moore, 1989; Thompson, McInnes, and Willard, 1991). The prevalence of this condition has been estimated to be anywhere from 1 in 12,500 births to 1 in every 60,000 births (Dreger, 1998).
Male pseudohermaphroditism may result from two or more causes. Individuals with androgen insensitivity syndrome (AIS) have an XY chromosome basis and testes but are unable to respond to testosterone produced by the testes as the result of an androgen receptor defect (Groveman, 1999). The androgen insensitivity may be partial or complete (Mignon, Brown, and Fichman, 1981). As a result of this
deficiency, the genitals may appear to be those of a female and the secondary sex characteristics may also be those of a female. Researchers have estimated that approximately 1 out of every 120,000 individuals have AIS (Jagiello and Atwell, 1962). Many individuals with AIS may not know that they have this condition until they seek medical advice during puberty because of their failure to menstruate (Dreger, 1998).
Male pseudohermaphroditism may also result from a condition known as 5- alpha-reductase (5-AR) deficiency. These individuals are genetically and gonadally male, but as a result of this condition, their external genitalia appear feminine at birth (Wilson and Reiner, 1999). The enzyme 5-alpha-reductase is critical to the conversion of testosterone to dihydrotestosterone. Although the testes of the child produce testosterone during fetal development, the testosterone is not converted due to the deficiency of this enzyme. As a result, the fetus develops genitalia that appear to be those of a female. However, additional testosterone is produced by the testes at puberty; this testosterone is adequate to produce “masculine”
features because the enzyme is not required to process the testosterone at puberty.
Individuals with this condition may develop facial hair, the testes may descend, and what was believed to be a clitoris may grow and look more like a penis (Wilson, 1992).
Ambiguous genitalia may also result from a number of other conditions, such as Klinefelter’s syndrome and Turner’s syndrome (Wilson and Reiner, 1999). In Klinefelter’s syndrome, the male child has an XXY chromosomal basis, while in Turner’s syndrome, a girl is missing all or part of her second X chromosome.
Ultimately, what is considered to be hemaphroditism or ambiguous sex will depend in any given context on what is accepted within a given culture and context as a normal variation of maleness/malehood or femaleness/femalehood and what is considered to be truly ambiguous. This, in turn, requires the identification of the characteristics that are believed to be critical to the status of malehood and femalehood. Kessler (1998) has argued for the characterization of intersexuality as a reflection of variability, rather than ambiguity. Genitals that vary in form from a predetermined standard may embody a number of different meanings: (1) the genitals do not reflect either of the two traditional gender categories and testing is consequently warranted; (2) the genitals reflect the “wrong” gender category, therefore necessitating surgical correction; (3) the genitals do not conform to the known gender but will correct themselves; (4) the nonconforming genitals are in- dicative of an underlying medical condition that requires nonsurgical intervention;
(5) the genitals are inferior and require surgical correction; (6) the genitals are superior and are the object of envy; (7) the genitals vary from person to person;
or (8) the nature of one’s genitals reflects the misbehavior or genetic unsuitability of his or her parents. Just as the meaning that attaches to “ambiguity” varies over time and place, so too may the interpretation given to perceived variability. In- deed, “variability” can only be perceived in reference to a predetermined standard of desirability and/or normality.
The Intersex Society of North America (ISNA) seeks the cessation of all intersex- related surgery until an individual can consent for him- or herself. ISNA has argued that intersex surgeries are more appropriately termed “intersex genital mutilation,”
or IGM, in a manner analogous to ritualized cutting of female genitalia, also known as female genital mutilation (FGM) and female circumcision (Kessler, 1998).
Gender, Gender Role, and Gender Identity
Gender and Gender Role
Traditionally, one’s biological sex has been linked to one’s gender, gender role, and social identity. One scholar observed this seemingly inextricable linkage of the two concepts with the following example:
[W]omen’s low brain weights and deficient brain structures were analogous to those of lower races, and their inferior intellectualities explained on this basis. Women, it was observed, shared with Negroes a narrow, childlike, and delicate skull, so different from the more robust and rounded heads characteristics of males of “superior” races. Similarly, women of higher races tended to have slightly protruding jaws, analogous to, if not exaggerated as, the apelike jutting jaws of lower races. Women and lower races were called innately impulsive, emotional, imitative rather than original, and incapable of the abstract reasoning found in white men (Stepan, 1990: 39–40).
Stoller distinguished the concepts of sex and gender, arguing that sex is a function of biology, while gender is a function of culture:
Dictionaries stress that the major connotation of sex is a biological one as, for example, in the phrases sexual relations or the male sex . . . . It is for some of these psychological phenomena [behavior, feelings, thoughts, fantasies] that the term gender will be used: one can speak of the male sex or the female sex but one can also talk about masculinity or femininity and not necessarily be implying anything about anatomy or physiology (Stoller, 1968: viii–ix).
However, Stoller also appears to rely on biology in defining gender when referring to normality of masculinity and femininity:
Gender is a term that has psychological and cultural rather than biological connotations; if the proper terms for sex are “male” and “female,” the proper terms for gender are “masculine”
and “feminine”; the latter may be quite independent of (biological) sex. Gender is the amount of masculinity or femininity found in a person and, obviously, while there are mixtures of both in many humans, the normal male has a preponderance of masculinity and the normal female a preponderance of femininity. (Emphasis added.)
In contrast, gender has been defined as
a multidimensional category of personhood encompassing a distinct pattern of social and cultural differences. Gender categories often draw on perceptions of anatomical and physi- ological differences between bodies, but those perceptions are always mediated by cultural categories and meanings . . . . Gender categories are not only “models of” difference . . . but also “models for” difference. They convey gender-specific expectations for behavior and temperament, sexuality, kinship and interpersonal roles, occupation, religious roles and other social patterns. Gender categories are “total social phenomena” . . . .; a wide range of institutions and beliefs find simultaneous expression through them, a characteristic that distinguishes gender from other social statuses (Roscoe, 1994: 341).
Yet another scholar explained:
Gender is a way in which social practice is ordered. In gender processes, the everyday conduct of life is organized in relation to a reproductive arena, define by bodily structures and processes of human reproduction. This arena includes sexual arousal and intercourse, childbirth and infant care, bodily sex difference and similarity.
I call this a ‘reproductive arena’ not a ‘biological base’ to emphasize the point . . . that we are talking about a historical process involving the body, not a fixed set of biological determinants. Gender is a social practice that constantly refers to bodies and what bodies do, it is not a social practice reduced to the body . . . Gender exists precisely to the extent that biology does not determine the social. It marks one of those points of transition where the historical process supersedes biological evolution as the form of change (Connell, 2005: 71).
Gender role, then, is
[e]verything that a person says and does, to indicate to others or to the self the degree that one is either male, or female, or ambivalent; it includes but is not restricted to sexual arousal and response (Money and Erhardt, 1972).
The adoption of a “male” style of dress and behavior by “sworn virgins” of northern Albania serves to illustrate how specific behaviors and other social pat- terns are associated with a specific gender and reflected in gender role. The “sworn virgins” vow to become men and dress and behave in a manner consonant with the societal expectations of men (Young, 2000). Several motives have been identified for this course of action:
In traditional Albanian society there is no such sophisticated (and expensive) surgical assis- tance for social and psychological transition. However, the reasons for the female-to-male cross gender role taken on by the women . . . have less to do with the individual than the social, economic, and cultural situation into which they are born. Early records refer pre- dominantly to this as the only acceptable alternative to not marrying the man to whom a woman was betrothed. Another strong reason to encourage the change of gender is in order to become eligible to become a family head and a legal heir—an essential role to be filled in every family. Lack of a son of sufficient age and integrity (representing honour for a family) may bring shame . . . In order to cross the boundary from a woman’s world to a man’s domain, it is necessary to change sex socially: this is done by dressing as a man and socially engaging in activities limited to men (Young, 2000: 57).
As yet another example, we may consider the “mainstream” conceptualization of male and female gender and gender roles in the United States. Defining a “man,”
apart from a biological definition that incorporates hormone levels, chromosomes, and genital organs, is inextricably linked to our definition of “masculinity” (White- head and Barrett, 2001). “Masculinities” have been defined as
those behaviours, languages and practices, existing in specific cultural and organizational locations, which are commonly associated with males and thus culturally defined as not feminine. So masculinities exist as both a positive, inasmuch as they offer some means of identity signification for males, and as a negative, inasmuch as they are not the ‘Other’
(feminine) (Whitehead and Barrett, 2001: 15–16).
Seemingly, however, maleness and masculinity do not come naturally. Badinter (1995: 1–2) observed:
The order so often heard—“Be a man”—implies that it does not go without saying and that manliness may not be as natural as one would like to think. At the very least, the exhortation signifies that the possession of a Y chromosome or male sex organs is not enough to define the human male. Being a man implies a labor, an effort that does not seem to be demanded of a woman . . . .Without being aware of it, we behave as though femininity were natural, therefore unavoidable, whereas masculinity must be acquired, and at a high price. The man himself and those who surround him are so unsure of his sexual identity that proofs of his manliness are required . . . Yet the display of proofs requires trials that a woman does not have to undergo. The day of her first period comes naturally, without effort if not without pain, and now the little girl is declared a woman forever. There is nothing like this, nowadays, for a little boy belonging to Western civilization.
The more positive traits associated with masculinity include a willingness to sacrifice self for family; loyalty, dedication, and commitment; the ability to solve problems and the willingness to take risks to do so; and self-reliance, fortitude, persistence, and calm (Levant, 1995). And, although conceptions of masculinity vary across different American subgroups, is has been asserted that
there is a core which is common to most: courage, endurance and toughness, lack of squeamishness when confronted with shocking or distasteful stimuli, avoidance of display in weakness in general, reticence about emotional or idealistic matters, and sexual competency (Stouffer, Lumsdaine, Lumsdaine et al., 1976).
Manhood in the United States, then, has been defined through various restrictive, societally-imposed edicts:
1. “No Sissy Stuff.” One may never do anything that even remotely suggests femininity. Masculinity is the relentless repudiation of the feminine.
2. “Be a Big Wheel.” Masculinity is measured by power, success, health, and status. As the saying goes, “He who has the most toys wins when he dies.”
3. “Be a Sturdy Oak.” Masculinity depends on remaining calm and reliable in crises, holding emotions in check. In fact, proving you’re a man depends on never showing your emotions at all. Boys don’t cry.
4. “Give ‘em Hell.” Exude an aura of manly daring and aggression. Go for it. Take risks. (Brannon, 1976).
Similarly, the “masculine mystique” emphasizes restrictive emotionality, health care problems, obsession with achievement and success, restricted sexual and affectionate behavior, and concerns about power, control, competition, and homo- phobia (O’Neil, 1982). The “elements” of the male role have been said to include
“the anti-feminine element,” the “success element,” the “aggressiveness elements,”
and the “sexual element” (Doyle, 1989).
It has been argued that, as a consequence, the birthright of every American male is a chronic sense of personal inadequacy (Woolfolk and Richardson, 1978) and that men’s true fear “is not fear of women but of being ashamed or humiliated in front of other men, or being dominated by stronger men” (Leverenz, 1986: 451). If
this is, indeed, true, then homophobia has little to do with homosexual experience and everything to do with, as one man stated,
the fear that other men will unmask us, emasculate us, reveal to us and the world that we do not measure up, that we are not real men. We are afraid to let other men see that fear.
Fear makes us ashamed, because the recognition of fear in ourselves is proof to ourselves that we are not as manly as we pretend. . . . (Kimmel, 2003: 104).
It has been hypothesized that, as a result, the development of male gender identity involves the construction of positional identities, whereby a sense of the self is solidified through separation from others (Chodorow, 1978). This stands in sharp contrast to the development of female gender identity, which often involves the definition of self through one’s connections with others (Gilligan, 1982). For men who both fear and desire connection with others, organized sports provides a mechanism for interaction, while still focusing on hierarchical position, e.g., being number one (Messner, 2003).
The establishment of positional identity is evident in other domains, as well.
One psychiatrist commented:
Men become depressed because of loss of status and power in the world of men. It is not the loss of money, or the material advantages that money could buy, which produces the despair that leads to self-destruction. It is the “shame,” the “humiliation,” the sense of personal “failure”. . . . A man despairs when he has ceased being a man among men (Gaylin, 1992: 32).
Accordingly, this process of establishing and asserting one’s identity is said, then, to explain much of heterosexual male behavior in the United States: men must act in a way that eliminates any possibility that others will get the “wrong idea”: withholding any expression of feelings, displaying sexual predation with women, walking and talking in a specified manner (Kimmel, 2003). There are, however, exceptional situations in which men are permitted to behave in ways that, under other circumstances, would negate their masculinity. Depictions of war, for instance, allow men to hold and comfort each other (Easthope, 1986).
It has been argued, though, that the establishment of a male identity has become increasingly difficult for men due to relatively recent profound changes in men’s situations: women’s increasing exercise of choice in relationships, divorce, and child-bearing; the decreasing likelihood that men will enjoy a secure, life-long career or employment situation; the increasing number of dual-income households in lieu of households where the male is the sole breadwinner; and the increasing visibility of groups once relegated to society’s margins, such as gay men, women, and persons of color (Whitehead and Barrett, 2001).
Violence, it has been asserted, or the willingness to engage in violence, con- stitutes one mechanism for the establishment of manhood and masculinity or, in other words, positional identity (Gilligan, 2001; Kimmel, 2003). This is reflected in the observation that the insults most shaming to men are those that challenge the existence or the extent of their courage or manliness, including their sexual adequacy: “wimp,” “coward,” “sissy,” “fairy” (Gilligan, 2001: 571). One writer observed:
Little boys learn the connection between violence and manhood very early in life. Fathers indulge in mock prize fights and wrestling matches with eight-year-olds. Boys play cowboys and Indians with guns and arrows proffered by their elders. They are gangsters or soldiers interchangeably—the lack of difference between the two is more evident to them than to their parents. They are encouraged to “fight back,” and bloodied noses and black eyes become trophies of their pint-sized virility (Komisar, 1976).
In contrast to men, women are shamed by insults that allude to their being too much like men: too independent, too aggressive; transposed into a sexual context, this becomes a “bitch,” “whore,” “tramp,” or “slut.” Not surprisingly, in a survey of both men and women, men expressed their greatest fear as being laughed at. In contrast, women’s greatest fear was of being raped and murdered (Noble, 1992). It is of note that the term “cuckhold,” meaning an inability to control one’s partner’s sexuality, is applied exclusively to men, whereas the term “promiscuous” is used almost exclusively to refer to women’s behavior (Gilligan, 2001).
Exclusionary devices offer an additional route for the establishment and main- tenance of a positional hierarchy. Through exclusion, those deemed less manly are relegated to lower positions in the hierarchy—women, gay men, men of color, non- native-born men, men of lower socioeconomic status. Those men deemed to be less
“manly” reflect subordinate and marginal masculinities (Whitehead and Barrett, 2001). Through exclusion, “manhood” embodies sexism, racism, and homophobia (Kimmel, 2003).
Notman (1982: 4) has explained that “Femininity is very difficult to define because the word is used in a number of ways. It can be used descriptively, norma- tively, diagnostically, clinically, and colloquially.” Early concepts of femininity, such as those espoused by Freud and Deutsch, consisted of a triad of character- istics: passivity, masochism, and narcissism (Deutsch, 1944, 1945; Freud, 1961).
More recent psychoanalytic thought has been careful to distinguish between gen- der identity, gender role, and the qualities of masculinity and femininity (Notman, 1982).
In contrast to this psychoanalytic perspective, Bartky (1990: 65) has argued that We are born male or female, but not masculine or feminine. Femininity is an artifice, an achievement, ‘a mode of enacting and reenacting received gender norms which surface as so many styles of the flesh’ (quoting Butler, 1985: 11).
Femininity, according to Jay (1981) has been said to represent the not- masculinity, the not-A. This view has been reflected in popularly marketed lit- erature. For instance, a 1948 book explained to teen-age girls that “the normal boy is attracted to the completely feminine girl” and the “normal girl” likes “a man who is completely masculine, the direct opposite of you” (Bryant, 1948, emphasis in original).
The ideal depiction of the feminine girl was represented at one time by the figure of Jane in the dyad of Dick and Jane, the characters who first appeared in all of the stories in the 1930 Elson Basic reader pre-primer. It has been estimated that by 1950, 80% of all first-graders in the United States were learning to read by growing up with Dick and Jane (Kismaric and Heiferman, 1996).
Dick of Dick and Jane embodied the ideal of the all-American boy: confident, direct, responsible, organized, in control, resourceful, and well-behaved. Jane, on the other hand, never quite measured up to the same standard. She has something new to wear on every page; in fact, her dresses never wrinkled and never dirtied.
Jane never sulked and never lost her temper. Her hair was not too curly, but not too straight; Jane was not too fat, but not too thin. Jane reflected what girls should be: “The ideal middle-class girl of the 1950s was ladylike and wore dresses ev- erywhere, accessorized with hats, shoes, purses and clean white gloves to create a total ‘look”’ (Kismaric and Heiferman, 1996: 26). While Dick was a character of substance, with real personality and strength, Jane was a superficial soul, delighted to look pretty and look wistfully on while Dick accomplished his successes. Little Sally, the baby of the family, depicted yet another aspect of the feminine: the doll baby who was always active, unthinkingly creating difficulties, and making people laugh with her antics. Jane and Sally were both blondes, unlike Dick, who was dark-haired.
Mother of the Dick and Jane series reflected similar features. Mother was blond, pretty, a good partner to Father, a nurturer of the children and her husband, an effortless homemaker. Mother likes to look good and “dresses like a lady” in pretty dresses (even while doing housework) and has matching pocketbooks. Mother always remembered to sit with her ankles crossed and her hands clasped. According to some writers, she does not work outside of the home, because her place is in the home, making sure that everything is always in its rightful place (Havemann and West, 1952). In fact, careers would lead to the
masculinization of women with enormously dangerous consequences to the home, the children dependent on it and to the ability of the woman, as well as her husband, to obtain sexual gratification (Friedan, 1963: 42, quoting Farnham and Lundberg).
Instead, Mother is selfless and soothing, dedicating her life to her family (Kismaric and Heiferman, 1996). As late as the 1960s, women’s magazines encouraged their readers to assume such characteristics:
Psychiatrists call this characteristic “essential feminine altruism.” Simply stated, it means that the hallmark of real femininity is. . . regard for and devotion to the interests of oth- ers. . . For the true woman, then, children and husband come first, way before self, for that is how her altruism expresses itself (Robinson, 1960: 62).
At least through the 1950s, the popular U.S. conceptualization of femininity sometimes appeared to minimize or negate the possession of intelligence or ed- ucation. The Jungian analyst Mrs. Florida Scott-Maxwell (1958: 156) counseled her readers in Ladies’ Home Journal:
When a woman begins to understand herself, she understands she has a masculine side as well as a feminine side and that masculine side is in constant danger of getting out of hand in our industrial, emancipated society. When a girl is in college and cultivates her mind, this may stimulate, even inflate, the masculine side, and she can become aridly intellectual, with a strong power drive, and then it is easy to become a doctor or a lawyer who is hardly feminine at all.
According to other writers, however, such as Duvall and Hill (1947: 210), some women risked their marriages if they failed to work:
Some women are temperamentally so built that if they do not have a job of their own they either “blow up” or constantly meddle in the affairs of their husbands, and possibly those of other husbands as well. With them a real job outside of the office meets a vital psychological need.
Women working in the office were counseled to be feminine and not just female:
Your over-all appearance should be such that the people with whom you are working will be aware of the fact that you are feminine, not just female. . . To be “female” at the office is a nuisance and therefore a waste of after-hours attractions (Ludden, 1956: 166).
Jane, like Dick and the world that they lived in, was entirely white. It was not until 1965 that non-white characters appeared to inhabit Dick and Jane’s idyllic world. For over 30 years, “femininity” had been defined for school-aged children as applying to white girls and women only.
Femininity has also been equated with a particular body build or image. For instance, columnist Dolly Martin wrote in 1964, in seeming surprise, that “It’s hard to picture a girl of large build being quite feminine, yet many chubby girls have very pleasing tendencies” (Martin, 1964: 8). Bartky (1990) has asserted that the construction of a “feminine” body from a female one, that is, the aesthetic of femininity, demands fragility and a lack of muscular strength, resulting in the inability to defend oneself physically; smooth and hairless skin, thereby infan- tilizing the body of grown women; and body language that is reflective of both tension and constriction. Ultimately, Bartky argues, women’s adherence to this
“performance” may engender attention, but affords little respect or social power and serves to demean everything that is female. In fact, women’s attempts to adhere to an externally-imposed construction of femininity actually results in the diminu- tion of women specifically because of this focus on what could be considered trivialities, such as body image. Bartky (1990: 80) maintains that the
woman who checks her make-up half a dozen times a day to see if her foundation has caked or her mascara run, who worries that the wind or rain may spoil her hairdo, who looks frequently to see if her stockings have bagged at the ankle, or who, feeling fat, monitors everything she eats, has become . . . a self-policing object, a self committed to a relentless self-surveillance. This self-surveillance is a form of obedience to patriarchy.
Gender Identity and Sexual Identity
Gender identity and gender role are also distinct concepts:
Gender identity has been defined as the private experience of gender role: the experience of one’s sameness, unity and the persistence of one’s individuality as male, female, or androgynous, expressed in both self-awareness and in behavior. Gender role is everything that a person says and does to indicate to others or to the self the degree to which one is either male, female or androgynous. Gender role would thus include public presentations of self
in dress and verbal and nonverbal communication; the economic and family roles one plays;
the sexual feelings (desires) one has and the persons to whom such feelings are directed;
the sexual role one plays and emotions one experiences and displays; and the experiencing of one’s body, as it is defined as masculine or feminine in any particular society. Gender identity and gender role are said to have a unity, like two sides of a coin (Nanda, 1994:
395–396).
Money and Erhardt (1972) similarly distinguished between the concept of gender and that of gender identity:
Gender Identity: The sameness, unity, and persistence of one’s individuality as male, female, or ambivalent, in greater or lesser degree, especially as it is experienced in self awareness and behaviour; gender identity is the private experience of gender role, and gender role is the public expression of gender identity.
Stoller also discusses gender identity and gender role as they relate to the public- private distinction:
I am using the word identity to mean one’s own awareness (whether one is conscious of it or not) of one’s existence or purpose in this world or, to put it a bit differently, the organization of those psychic components that are to preserve one’s awareness of existing (Stoller, 1968: x).
The concept of gender identity is also distinguishable from that of core gender identity, which represents a “person’s unquestioning certainty that he belongs to one of only two sexes” (Stoller, 1968: 39):
This essentially unalterable core of gender identity [I am a male] is to be distinguished from the related but different belief, I am manly (or masculine). The latter attitude is a more subtle and complicated development. It emerges only after a child learned how his parents expect him to express masculinity (Stoller, 1968: 40).
In contrast to core gender identity, which signifies the feeling that “I am a male”
or “I am a female,” gender role represents “a masculine or feminine way of be- having” (Walinder, 1967: 74). The concept of sexual identity is also distinct, in that it
is ambiguous, since it may refer to one’s sexual activities or fantasies, etc. . . . Thus, of a patient who says “I am not a very masculine man,” it is possible to say that his gender identity is male although he recognizes his lack of so-called masculinity (Stoller, 1964:
220).
Transsexuality and Transgenderism
Transsexuality
The term transsexual has been used to refer to “individuals with a cross-sex iden- tity,” regardless of their surgical status or apparent biological sex (Bolin, 1992:
14). The fourth edition of the Diagnosis and Statistical Manual of the American
Psychiatric Association classified transsexuality as a gender identity disorder re- sulting in “clinically significant distress or impairment in social, occupational, or other important areas of functioning” (Reid and Wise, 1995: 241). Diagnosis of the
“disorder” was premised on the existence of a “strong and persistent cross-gender identification” and “a persistent discomfort with one’s sex or a sense of inappro- priateness in the gender role of that sex” (Reid and Wise, 1995: 241). In addition, a diagnostic finding of transsexuality required differentiation from hermaphroditism, from a desire to change sex due to nonconformity with prescribed sexual roles, and from a desire to change sex to achieve a social or cultural advantage (Reid and Wise, 1995: 240). The current edition of the Diagnostic and Statistical Manual, DSM-IV-Text Revision, subsumes transsexuality within the classification of gender identity disorders (American Psychiatric Association, 2000). Table 3 indicates the basis for such a diagnosis in both children and adults.
It has been estimated that 1 out of every 11,900 men (male to female) and 1 out of every 30,400 women (female to male) are transsexual (Bakker, van Kesteren, Gooren, and Bezemer, 1993). Estimates of the male-female sex ratio have varied widely, ranging from 2.5 to 1 in the Netherlands to 5.5 to 1 in Poland (Bakker et al., 1993; Godlewski, 1988; Pauley, 1968).
Treatment for transsexualism has often consisted of long-term hormonal therapy and sex change surgery. Genital reassignment surgery from female to male is complex and extensive, requiring several stages to be completed (Hage, Bouman, de Graaf, and Bloem, 1993). Phalloplasty is used to construct a penis for female-to- male transsexuals (Hage, Bloem, and Suliman, 1993). Female-to male transsexuals often adhere to a long-term regimen of androgen administration in addition to undergoing surgery (Sapino, Pietribiasi, Godano, and Bussolati, 1992). Potential adverse outcomes may include necrosis, hernia, venous congestion, and phallic shaft fistulas (Hage, Bloem, and Suliman, 1993).
Male-to-female transsexuals wishing to modify their genitalia must also un- dergo extensive surgery (Eldh, 1993) and hormonal treatment (Valenta, Elias, and Domurat, 1992). Potential adverse outcomes include the lack of a sensate clitoris (Eldh, 1993), vaginal stenosis (Crichton, 1992; Stein, Tiefer, and Melman, 1990), and pain during sexual intercourse (Stein et al., 1990). The transition from male to female may also be emotionally stressful and difficult (Ames, 2005; Brevard, 2001; Griggs, 2004; Just Evelyn, 1998; Martino, 1977).
Many transsexual individuals may decide to forego surgery due to its high cost and lack of insurance coverage for such procedures (Gordon, 1991; Stein et al., 199) and the fear of an unsatisfactory surgical outcome (Crichton, 1992; Hage, Blout, Bloem, and Megens, 1993).
Transgenderism
The term transgender can be used to refer to (1) all those “who challenge the bound- aries of sex and gender (Feinberg, 1996: x), (2) those who modify their sex with which they were labeled or identified with at birth, and (3) those individuals whose expressed gender is considered inappropriate for their apparent sex (Feinberg,
TABLE3. Diagnostic criteria and symptoms for gender identity disorders
Symptoms Symptoms
Diagnostic criterion exhibited by children exhibited by adults Strong and persistent
cross-gender identification
Four of the following: Stated desire to be of the opposite sex Consistent statements that he or
she is a member of the other sex or wishes to be a member of the opposite sex
Passing frequently as a member of the opposite sex
Boys’ preference for cross-dressing or girls’
insistence on wearing stereotypical masculine clothes
A wish to live or be treated as a member of the opposite sex
An assumption of cross-sex roles in make-believe play or persistent fantasy of being of the opposite sex
Believing that he or she has the feelings of a member of the opposite sex
A strong wish to participate in games that are stereotypical of the opposite sex A strong preference to have
playmates of the opposite sex Persistent discomfort with
his/her sex or a sense that the gender role of that sex is inappropriate
Boys: revulsion with penis, wish that it would fall off, rejection of games and toys typically associated with boys
Focus on attempting to eliminate primary and secondary sex characteristics Girls: stated desire to grow a
penis and not to have breasts or menstruate
Belief that he/she was born a member of the wrong sex
Disturbance does not co-occur with a physical intersex condition
Disturbance causes “clinically significant distress or impairment in social, occupational, or other important areas of functioning”
Adapted from American Psychiatric Association (2000).
1996). Transgender individuals may be distinguished from transsexuals, who change or modify the sex that they were assigned at birth; in contrast to trans- sexuals, transgender individuals have been defined as those who “blur the [bound- aries] of the gender expression” that is traditionally associated with the biological sexes (Feinberg, 1996). It has been asserted that “the guide principle of this [trans- gender] movement is that people should be free to change, either temporarily or permanently, the sex type to which they were assigned since infancy” (Rothblatt, 1995: 16).
Cross-dressing represents one such form of blurring (Garber, 1992). Cross- dressing, or wearing the clothing that is most frequently associated with the oppo- site biological sex, occurs for various reasons in numerous contexts; in fact, it may not be associated with transgenderism, depending upon its purpose and the context in which it occurs. Women may assume “an imitation man look” in order to succeed in business (Molloy, 1977). Males, regardless of their sexual orientation, may don women’s clothing to perform as female impersonators. Gay men may cross-dress as a means of self-assertion or activism (Garber, 1992). Cross-dressing has been central in theater (Baker, 1994; Heriot, 1975) and, to a lesser degree, in religion (Barrett, 1931; Garber, 1992; Warner, 1982).
Sexual Orientation
Choosing a Sexual Partner: Sexual Attraction, Sexual Activity, and Self-Identity
In contrast to the term “heterosexuality,” for which relatively few synonyms are used, homosexuality has been known by a vast number of other terms. These include uranianism, homogenic love, contrasexuality, homo-erotism, similsexual- ism, tribadism, sexual inversion, intersexuality, transexuality, third sex, and psy- chosexual hermaphroditism (Sell, 1997).
The apparent sex of one’s sexual or romantic partner is often equated with one’s sexual orientation. However, data indicate that homosexuality and homosexual behavior are not synonymous. One study of male sexual behavior in the United States found that 2% of the respondents ages 20 to 39 reported having had any same-sex sexual activity during the preceding 10 years, but only 1% reported exclusively same-sex sexual activity during the same time period (Billy, Tanfer, Grady, and Keplinger, 1993). An ethnographic study of men having sex with men found that only 14% of the individuals were primarily interested in homosexual relationships, over one-half of the men were married, and many of the married men engaged in sex with other men due to family planning concerns stemming from their observance of Catholic tenets relating to birth control (Humphreys, 1970).
Identical sexual acts, including the choice of one’s sexual partner, may vary in meaning and significance depending upon the cultural and historical context of the activities (Vance, 1995).
Homosexual behavior, as distinct from homosexuality, may reflect differentials in power and status between the partners. For instance, individuals may agree to participate in sex with an individual of the same sex in order to avoid the threat of increased violence; such situations are not uncommon in the context of living on the street (Scacco, 1992), imprisonment, and during war (Greenberg, 1988;
Trexler, 1995).
In a number of societies, sexual relations between younger and older men were structured by age (Greenberg, 1988). The older male often assumed the active role in a relationship, while the younger male assumed the passive role. The sexual
act could include masturbation, anal intercourse, and/or fellatio. The motivation for these relationships varied depending on the culture, but could derive from the belief that the older male could transmit special healing powers to the younger male through these acts; that physical maturation of the younger male required the implantation of semen in his body by an older adult; and/or that heterosexual inter- course would deplete one’s vitality and/or harm men as a result of women’s pollut- ing qualities (Greenberg, 1988). Additionally, sex with other men may be a means of satisfying one’s sexual needs in the absence of an adequate number of women.
The status of Native American berdache and Asian Indian hijra have often mistakenly been equated with homosexuality. A berdache has been defined as “a morphological male who does not fit society’s standard man’s role, who has a nonmasculine character” (Williams, 1992: 2). Native Americans often referred to berdaches as “halfmen-halfwomen,” although they were neither transsexuals nore hermaphrodites. Berdaches, now more commonly referred to as “two-spirit people”
(Lang, 1996), existed within a number of Native American tribes, including the Cheyenne, Creek, Klamath, Mohave, Navaho, Pima, Sioux, and Zuni (Greenberg, 1988; Roscoe, 1991; Williams, 1992). Two-spirit people have been described as androgynous and have been perceived as being of an alternative gender due to their use of the behaviors, social roles, and dress of both men and women. Although some individuals assumed the passive/receptive role in a sexual relationship with another man, the sexual relationship was a secondary component of one’s status as a berdache (Callender and Kochens, 1985; Williams, 1992). Similarly, some two- spirit women adopted some male roles and dress and had sexual relations with women (Schaeffer, 1965). The berdache tradition, however, has declined due to missionary and U.S. government efforts. Additionally, younger Native Americans may have rejected the role of the berdache and self-identify, instead, as gay males (Williams, 1992).
The hijras of India have been called “neither man nor woman and woman and man” (Nanda, 1990, 1994). In the past, hijras have played a religious role, derived from Hinduism, by blessing newborn male children and performing at wedding ceremonies (Nanda, 1990). Hijras are defined as such by their lack of sexual desire for and sexual impotence with women, rather than by their sexual relations with men. Their impotence with women has been attributed to a defect in or absence of male sexual organs from birth or through their surgical removal (Nanda, 1990).
Hijras self-define as “not men” due to their impotence with women and as “not women” because of their inability to bear children; as such, they collapse sex and gender into one category. They incorporate various aspects of the female role, such as dress, gendered erotic fantasies, a desire for male sexual partner, and a gender identity of a woman or hijra, with those of a male role, which include coarse speech and the use of the hookah for smoking (Nanda, 1994). Despite their sexual relations with other men, hijras do not self-define as homosexuals.
Sexual Orientation
The identification of an individual’s sexual orientation is quite complex. The be- havioral view of sexual orientation asserts that one determines sexual orientation
by reference to the sex of the individual with whom one is involved sexually: if it is an individual of the same sex, then one is a homosexual, while if the person is of the opposite sex, one is heterosexual (Stein, 1999). However, this viewpoint suffers from a number of limitations. First, it equates behavior with orientation, despite the possibility that there may be multiple explanations for the same behav- iors. Second, it assumes that only two sexual orientations exist. Third, the theory is concerned with whether the sexual partner is of the same or opposite sex, rather than whether the sexual partner is a man or woman. Additionally, it is unclear as to the exact point in time at which this assessment is to be made: Is it premised on the sex of the first person with whom one has sexual relations? The sex of the most recent partner? The sex of the majority of partners during one’s lifetime? If the latter, at what point in an individual’s lifetime can “majority of partners” be determined with accuracy, short of one’s death?
The self-identification view asserts that individuals’ sexual orientation is iden- tifiable based on their beliefs about themselves; if someone believes, for instance, that he or she is heterosexual, then he or she is heterosexual. This view fails to con- sider instances in which an individual may experience attraction towards a member of the same sex, but not classify such feelings as homoerotic (Stein, 1999).
The dispositional view seemingly melds the basic tenets of the behavioral and self-identification perspectives. According to this view, an individual’s sexual ori- entation is a function of both his or her sexual desires and fantasies about sexual relations with members of a specific sex and his or her choice of sexual partner under ideal conditions. This perspective allows for the possibility that an individual may have a sexual orientation before he or she actually ever has sexual relations.
This perspective is not, however, without its difficulties, in that it may not be pos- sible to know what an individual’s choice of partner would be under circumstances that do not exist.
The Kinsey scale of sexual orientation has been termed a dispositional one because it simultaneously considers an individual’s sexual behavior, sexual desires, and sexual fantasies in determining sexual orientation and also recognizes that these features may be discordant within the same individual (Stein, 1999). Kinsey and colleagues explained:
[T]he rating which an individual receives has a dual basis. It takes account of his overt sexual experience and/or his psychosexual reactions. In the majority of instances, the two aspects of the history parallel, but sometimes they are not in accord. In the latter case, the rating of an individual must be based upon an evaluation of the relative importance of the overt and the psychic in his history . . . The position of an individual on this scale is always based upon the relation of the heterosexual to the homosexual in his history, rather than upon the actual amount of overt experience or psychic reaction (Kinsey, Pomeroy, and Martin, 1948:
647).
Sexual orientation has traditionally been viewed as a binary phenomenon: het- erosexual and homosexual (Stein, 1999). This construction of sexual orientation does not permit the existence, for instance, of bisexuality, and is unable to explain situational same-sex behaviors, such as male-male sex in prison for the purpose of self-protection or due to force.
In contrast, the bipolar construction views sexual orientation along a continuum, with exclusive heterosexuality at one end and exclusive homosexuality at the other (Kinsey, Pomeroy, and Martin, 1948). The Kinsey seven-point scale reflects this polarity with respect to sexual experience and desires:
0 = exclusively heterosexual, no homosexual
1 = predominately heterosexual, only incidental homosexual
2 = predominately heterosexual, but more than incidental homosexual 3 = equally heterosexual and homosexual
4 = predominately homosexual but more than incidental heterosexual 5 = predominately homosexual, but only incidental heterosexual 6 = exclusively homosexual with no heterosexual
X= no social-sexual contacts or reactions (Kinsey, Pomeroy, and Martin, 1948).
However, Kinsey’s conceptualization of sexuality as a heterosexual-homosexual continuum has been challenged by a number of researchers. Stein (1999) has criti- cized this schema, noting that the classification of bisexuals as equally heterosexual and homosexual fails to consider the diversity that exists within bisexuality. For instance, individuals may be strongly attracted to individuals of both the same sex and the opposite sex, or they may be moderately attracted to individuals of both sexes, or they may be weakly attracted to individuals of both sexes.
Storms (1979, 1980, 1981) has argued that sexual orientation may be conceived of along two axes: one axis represents the degree of attraction to individuals of the same sex-gender and the second axis refers to the degree of attraction to those of a different sex-gender. Individuals are mapped on this grid without regard to their own physical sex, that is, without regard to whether they are male or female, but only with reference to the sameness or differentness of their partner’s sex.
Consequently, a male and a female may share the same position on the grid, despite the difference in their sex.
Stein (1999) has advocated a variation of this grid, which would utilize the y- axis to indicate the degree of attraction to women and the x-axis to represent the degree of attraction to men. The resulting grid would group together those who are attracted to men or women. He has further suggested the addition of a third axis to represent the degree of attraction to members of a third sex-gender and a fourth axis to depict the sexual object choice, such as heterosexual women, homosexual men, etc. Shively and De Cecco (1977) asserted that sexual orientation reflects two different continua, one of which represents the degree of heterosexuality and the other of homosexuality. In addition, sexual orientation is comprised of two different aspects, the physical preference and the affectional preference, each of which consists of heterosexual and homosexual continua. The Sell Scale of Sexual Orientation, developed by Gonsiorek, Sell, and Weinsrich (1995), assesses the frequency and strength of sexual interests, the frequency of sexual contacts, and self-identity in degrees of heterosexuality, homosexuality, and bisexuality. Klein (1978) characterized both heterosexuality and homosexuality as limited, whereas bisexuality was perceived of as tolerating ambiguity. (For a detailed discussion of measures of sexual orientation, see chapter 7.)
